How Dr. Elvira Lang Overcame Resistance to Implement Change, SCEH Keynote Excerpt

Dr. Lang delivers the keynote speech at the SCEH Annual Meeting.

 

Here is a transcript of her address:

From very early on when I came to the University Hospitals of Iowa, I had just inherited a Division that had gone through some very serious turf battles. My predecessors had been fleeing the place. There were some other unfortunate events that left the team convinced that all leadership is really bad and after them. So, I thought oh, I just came from Stanford where we had done these great trials, the Lancet publication… let’s just do a, what I would now call, Comfort Talk® training. I mean they should be delighted, and it will heal everybody.  Well there was a major palace revolution subsequently to that, and I said “Ok, fine if you don’t want to be trained… I’ll just train then the people who want to and I’ll get an outside trainer in who’s really very, very good and so we trained these people. So, then the patients liked it, so those people got more cookies. In those days it was still allowed to give a health care professional something of a little value, they also got nicer cards. Then the doctors wanted to rather work with them than the others which created these incredible frictions within the Division, and the people who hadn’t been trained complained bitterly that they hadn’t been trained.  So, I said, “Fine, we’ll have another training.” “Oh no we don’t want this.” Ok I said, “This time you’re all going to have to take it… but you don’t have to use the skills.” So, they all got trained. They all were swearing they weren’t using the skills but unbeknownst to us the hospital was collecting patient data about pain management, which we didn’t know. But after we heard about it, I said “well can I see the data?” And low and behold it turned out on the scale they used, they used a 0 to 5 scale, the people who had been trained against their will had the same reduced pain perception in the patients than the people who had been trained voluntarily. So, I think what it shows is that even if somebody is very unhappy about being trained or objecting doesn’t mean that they cannot take on the message once they have experience what it all means. And we even see this nowadays where sometimes the people who object the most are actually turning out to be the champions a little bit later.